ArticleAIDS (London, England)2014
Mortality trends in the era of antiretroviral therapy: evidence from the Network for Analysing Longitudinal Population based HIV/AIDS data on Africa (ALPHA).
Article in AIDS (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 1 of them a synthesis that pooled it.
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Who cites it
72 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cancer risk factors among people living with HIV/AIDS in China: a systematic review and meta-analysis.Scientific reports · 2017Pooled it
- Early HIV treatment and survival over six years of observation in the ANRS 12249 Treatment as Prevention Trial.HIV medicine · 2022Trial
- All-cause and cause-specific mortality trends among people with and without HIV in the Siaya health and demographic surveillance system, Kenya, 2011-2018.Global health action · 2026Article
- Hypertension is a marker of the micro-epidemiologic transition in ageing HIV populations in Kenya, Uganda and Tanzania (AFRICOS, 2013-2023).BMC public health · 2026Article
- Article
- Factors associated with mortality among people with advanced HIV disease in rural uganda: a retrospective study.BMC infectious diseases · 2025Article
- Age and gender profiles of HIV infection burden and viraemia: novel metrics for HIV epidemic control in African populations with high antiretroviral therapy coverage.International journal of epidemiology · 2025Article
- Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019.Global health action · 2024Article
- Cohort Profile Update: Magu Health and Demographic Surveillance System, Tanzania.International journal of epidemiology · 2024Article
- Mortality variability and differentials by age and causes of death in rural South Africa, 1994-2018.BMJ global health · 2024Article
- Serotonin Levels in Newly-Infected HIV-Positive: A Preliminary Study.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2024Article
- Hypertension and traditional risk factors for cardiovascular diseases among treatment naïve HIV- infected adults initiating antiretroviral therapy in Urban Tanzania.BMC cardiovascular disorders · 2023Article
- Syndemics of intimate partner violence among women in HIV endemic South Africa: geospatial analysis of nationally representative data.Scientific reports · 2022Article
- Modeling the potential impact of pre-exposure prophylaxis for HIV among men who have sex with men in Cameroon.BMC infectious diseases · 2022Article
- Predictors of All-Cause Mortality Among People With Human Immunodeficiency Virus (HIV) in a Prospective Cohort Study in East Africa and Nigeria.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Survival probability and factors associated with time to loss to follow-up and mortality among patients on antiretroviral treatment in central Kenya.BMC infectious diseases · 2022Article
- Implementation of tuberculosis and cryptococcal meningitis rapid diagnostic tests amongst patients with advanced HIV at Kamuzu Central Hospital, Malawi, 2016-2017.BMC infectious diseases · 2022Article
- Twin epidemics: the effects of HIV and systolic blood pressure on mortality risk in rural South Africa, 2010-2019.BMC public health · 2022Article
- Trends of HIV-Related Cancer Mortality between 2001 and 2018: An Observational Analysis.Tropical medicine and infectious disease · 2021Article
- Trends of HIV Mortality between 2001 and 2018: An Observational Analysis.Tropical medicine and infectious disease · 2021Article
12 more citing papers are in PubMed but not listed here.
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Authors and funding
19 authors.
Funding
Abstract
backgroundThe rollout of antiretroviral therapy (ART) is one of the largest public health interventions in Eastern and Southern Africa of recent years. Its impact is well described in clinical cohort studies, but population-based evidence is rare.
methodsWe use data from seven demographic surveillance sites that also conduct community-based HIV testing and collect information on the uptake of HIV services. We present crude death rates of adults (aged 15-64) for the period 2000-2011 by sex, HIV status, and treatment status. Parametric survival models are used to estimate age-adjusted trends in the mortality rates of people living with HIV (PLHIV) before and after the introduction of ART.
resultsThe pooled ALPHA Network dataset contains 2.4 million person-years of follow-up time, and 39114 deaths (6893 to PLHIV). The mortality rates of PLHIV have been relatively static before the availability of ART. Mortality declined rapidly thereafter, with typical declines between 10 and 20% per annum. Compared with the pre-ART era, the total decline in mortality rates of PLHIV exceeds 58% in all study sites with available data, and amounts to 84% for women in Masaka (Uganda). Mortality declines have been larger for women than for men; a result that is statistically significant in five sites. Apart from the early phase of treatment scale up, when the mortality of PLHIV on ART was often very high, mortality declines have been observed in PLHIV both on and off ART.
conclusionThe expansion of treatment has had a large and pervasive effect on adult mortality. Mortality declines have been more pronounced for women, a factor that is often attributed to women's greater engagement with HIV services. Improvements in the timing of ART initiation have contributed to mortality reductions in PLHIV on ART, but also among those who have not (yet) started treatment because they are increasingly selected for early stage disease.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.